Doctors want to know how CMS plans to display Sunshine payment data

Physician and industry trade groups want CMS to share more information on its plans for displaying payment data disclosed under the Sunshine Act. Specifically, they're asking the agency to explain how context will be provided to the general public around the dollar sums drugmakers ascribe to doctors for things like meals, travel, gifts, consulting and research.

In a letter sent yesterday to CMS administrator Marilyn Tavenner, the groups cited the government's release of Medicare claims data earlier this year, a release which included only “names and numbers” with no explanation of the data. “We do not believe this is an effective way to share data with the public and, in fact, can lead to confusion and misinterpretation,” wrote signers, which included 25 physician associations as well as the BIO and PhRMA trade groups.

Will members of the public accessing the database “know if dollars attributed to physicians represent things like speakers or grants from which physicians didn't personally benefit?” asked Robert Harbaugh, MD, president of the American Association of Neurological Surgeons, on a conference call today with reporters to explain the letter.

In the wake of the letter, which was first reported on the Wall Street Journal's Pharmalot blog yesterday, a CMS spokesman issued a brief response to the WSJ, saying that the agency plans to release “the nature of payment” for each transfer of value made to a physician or teaching hospital, as well as "context."

“I would reiterate our expression of interest prior to that context going public,” PhRMA's assistant general counsel, John Murphy, said on today's call.

The government is required by law to consult with industry and other parties in order to ensure that the Sunshine Act information made available to the public is presented in the appropriate overall context. Ensuring appropriate background is critical to helping the public understand various interactions, the groups said, yet so far they have not received any information as to how the data will be conveyed.

“We didn't get a direct response,” said Murphy.

CMS told MM&M that its context will involve a breakdown of payments made by industry to individual physicians by different categories (e.g., speaking fee, consulting, research) and that its ongoing outreach efforts include webinars, Open Door Forums, articles in medical society publications, and using social media outlets.

The letter writers called on CMS to bump up its outreach and education to physicians on what will be reported and what the reporting will look like. We "felt the educational efforts really hadn't reached most neurosurgeons," Harbaugh said.

The payment data are scheduled to become available September 30, covering the period of August to December 2013. Physicians have until August 27 to review and correct the data before it goes public.

Ongoing glitches

Harbaugh and Murphy are also concerned about ongoing glitches in the registration process for checking the accuracy of this data.

Earlier this month, when doctors were first allowed to log on to the government's website to check what payments have been ascribed to them by drug and device makers, some encountered an error message. Others have gotten only halfway through the sign-up process. CMS opened the site in early July to doctors who complete a two-step registration.

“Having tried to enroll, it's a very clumsy system at this point, and I would hope that we might be able to simplify physician registration and the procedure for challenging payments,” said Harbaugh, adding that doctors need to provide their DEA number, national practitioner and social security numbers.

He said he began the process yesterday. “I've tried to register. I made it through the first step. I'm still waiting for confirmation from CMS via email to do the next step.”

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